A new World Health Organization (WHO) report, launched on the sidelines of the G20 Health Ministers Meeting in Limpopo, South Africa, urges urgent action to guarantee that novel tuberculosis (TB) vaccines reach adolescents and adults in high-burden countries. The report, Catalysing Solutions for Equitable Global Access for Sustainable Financing for Novel Tuberculosis Vaccines for Adults and Adolescents, presents a first-of-its-kind analysis of anticipated barriers, market dynamics, and bottlenecks that could affect timely, equitable, and sustainable access to these vaccines.
“New TB vaccines have the potential to save millions of lives and transform the course of the epidemic,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “By harnessing the power of science, partnership, and finance, we can realize our shared vision to end TB.”
Developed by the TB Vaccine Accelerator Council’s Finance and Access Working Group, co-convened by WHO, the Government of South Africa, and Gavi, the Vaccine Alliance, the report identifies six priority actions to ensure sustainable and equitable access worldwide. These include developing catalytic financing instruments, generating country-level evidence, mobilizing resources, advocating for regional manufacturing in high-burden regions, promoting market transparency, and coordinating supply and demand efforts.
TB vaccines for adolescents and adults are critical to accelerating the fight against the world’s deadliest infectious disease. Each year, more than 10 million people fall ill with TB, and over a million die, primarily in low- and middle-income countries, with at least 70% of cases concentrated in G20 countries and regions.
Despite the urgent need, no new TB vaccines have been licensed in over a century. The Bacille Calmette-Guérin (BCG) vaccine, widely used in childhood immunization schedules, provides limited protection against pulmonary TB in adolescents and adults. As of September 2025, at least 16 new TB vaccine candidates are in clinical development, including six in phase III trials.
While the vaccine pipeline is accelerating and countries are beginning to prepare for rollout, access to supply and financing remains a key concern. Manufacturers face uncertainty regarding country demand and financing, with limited plans for regional manufacturing of late-stage vaccine candidates. The report projects that global demand for TB vaccines will outpace supply in the early years, with demand expected to exceed three billion regimens between 2030 and 2040. Initial supply gaps could delay access and reduce the vaccines’ public health impact. Procurement costs alone are estimated at US$ 5–8 billion over the decade, not including delivery and health system strengthening, and no dedicated funding has yet been earmarked for these vaccines.
To overcome these challenges, the report outlines six solutions: leveraging catalytic global financing and market-shaping instruments to incentivize manufacturers; generating early country-level evidence such as demand forecasts and cost-effectiveness studies; clarifying domestic and donor financing commitments to mobilize resources; establishing coordination platforms for supply and demand stakeholders; sharing critical product supply information to support country planning and transparency; and promoting technology transfer and licensing to manufacturers in high-burden regions to strengthen regional supply security and vaccine acceptance.
Modelling suggests that a TB vaccine with 50% efficacy for adolescents and adults could, over 25 years, prevent up to 76 million TB cases, save 8.5 million lives, reduce antibiotic use by 42 million courses, and save households up to US$ 42 billion.
WHO emphasizes that developing and implementing financing and access strategies is essential for planning and equitable distribution once new TB vaccines become available. The organization will continue working with stakeholders through the Finance and Access Working Group to advance these solutions and ensure that novel TB vaccines reach those who need them most.
